The vasectomy which you and your spouse have discussed should be considered as a permanent sterilization procedure. Reversal of vasectomy can be done, but it requires major surgery which is not always successful and not covered by insurance. Before making a decision, you should both understand the procedure itself and other alternatives such as condoms, birth control pills, foams, diaphragms, IUD's and so forth. Freezing sperm for later use after vasectomy is not a reliable alternative since frozen sperm do not remain viable for very long. Vasectomy should not be viewed as a way to solve sexual or marital problems.
Vasectomy interrupts the transportation of sperm. Sperm are still produced in the testes. The fate of the sperm will be discussed later. Production of male hormones also continues which means there will be no effect on your sexual abilities or characteristics. In addition, the prostate and seminal vesicles continue to produce seminal fluid. The ejaculate will therefore appear normal with orgasm.
We prefer to perform the vasectomy using local anesthesia. More than one day is often needed to recover prior to returning to work. Please make your post-op schedule flexible for this reason.
During this surgical procedure, local anesthesia is injected into the scrotum for anesthesia. One or two small incisions are then made to get at each vas deferens. You may be aware of tugging or pulling during the procedure, but be sure to tell your physician if there is any pain.
Complications from vasectomy are not common but, of course, may occur:
- Early: If any signs or symptoms of infection, bleeding, swelling or unusual pain occur, the office should be called for further advice. Such complications are possible in the immediate post-op period after any type of surgery.
- Late: Delayed complications peculiar to vasectomy can also occur since sperm are still produced by the testicles. Ordinarily, the sperm degenerate in the obstruced epididymis and the resulting proteins are re-absorbed by the body. The re-absorbed protein may result in formation of immune antibodies in the blood. To date, no harm from these sperm antibodies has been reported in humans.
- One rare complication is the development of spermatoceles if sperm break out of the obstructed thin-walled epididymis tube. This may result in bouts of pain and swelling. On rare occasions it may be necessary to schedule another minor surgical procedure to remove the epididymis.
- Another complication that we have already noted above is the sontaneous re-anastomosis (i.e. reconnection) of the ends of the vas deferens, resulting in reappearance of sperm in the ejaculated seminal fluid.
- Sperm granulomas (i.e. lump-like scar) may also occur at the vasectomy site if there is leakage of sperm.
If you have an allergy to medication or a specific bleeding problem, please discuss this with your physician.